Knotless suture and tissue securing method

Abstract

An illustrative example suture securing method includes moving a first member in an insertion direction into bone. The first member includes an eyelet and suture threaded through the eyelet transverse to the insertion direction. The method includes moving a second member relative to the first member in the insertion direction into a suture securing position where the second member traps the suture.

The invention claimed is: 
     
       1. A knotless suture and tissue securing method, comprising:
 placing a first member in a bone, the first member being situated near a distal end of an inserter, the inserter having a proximal end and a longitudinal axis between the distal end and the proximal end, the first member including an eyelet and having a suture threaded through the eyelet across the longitudinal axis; 
 manipulating the suture including moving the suture relative to the eyelet to bring soft tissue into a selected position near the bone; and 
 moving a second member relative to the first member in a distal direction toward the eyelet until the second member pins the suture against the second member in the bone to thereby securely hold the soft tissue in the selected position without tying knots in the suture. 
 
     
     
       2. The method of  claim 1 , wherein
 the second member comprises a screw and moving the second member in the distal direction comprises rotating the screw to advance the screw in the distal direction. 
 
     
     
       3. The method of  claim 1 , wherein
 the second member comprises a plug and moving the second member in the distal direction comprises using an impact force to advance the plug in the distal direction. 
 
     
     
       4. The method of  claim 1 , wherein
 the inserter comprises a handle near the proximal end; 
 the inserter comprises a first shaft and a second shaft; 
 
       and the method comprises
 using at least the first shaft for placing the first member in the bone; and 
 using at least the second shaft for moving the second member in the distal direction. 
 
     
     
       5. The method of  claim 1 , wherein 
       manipulating the suture comprises
 grasping two ends of the suture extending away from one side of the eyelet; and 
 moving the two ends of the suture in an at least partially proximal direction to draw the soft tissue into the selected position; 
 
       and 
       wherein
 moving the second member in the distal direction includes moving the second member into engagement with two portions of the suture between the two ends and the soft tissue; and 
 the two portions of the suture are respectively pinned against a surface on the second member. 
 
     
     
       6. The method of  claim 5 , wherein the two portions of suture are respectively pinned between an outer surface of the second member and the bone. 
     
     
       7. The method of  claim 5 , wherein
 the second member holds the two portions of suture in a fixed position relative to the bone to thereby securely fasten the soft tissue in the selected position without tying knots in the suture. 
 
     
     
       8. The method of  claim 1 , comprising
 threading the suture through the soft tissue so that two free ends of the suture are situated away from the soft tissue; 
 passing the two free ends of the suture through the eyelet to thread the suture through the eyelet across the longitudinal axis. 
 
     
     
       9. The method of  claim 1 , wherein
 the first member comprises a loop of suture. 
 
     
     
       10. The method of  claim 1 , wherein moving the second member at least partially covers the eyelet of the first member. 
     
     
       11. A surgical method, comprising:
 capturing a portion of soft tissue with a suture; 
 threading two free ends of the suture through an eyelet of a first member; 
 moving the first member in an insertion direction into bone, wherein the suture is threaded through the eyelet transverse to the insertion direction; 
 moving the two free ends of the suture relative to the first member to thereby position the soft tissue near the bone in a selected position; and 
 moving a second member relative to the first member in the insertion direction until the second member contacts the suture to securely fasten the soft tissue in place near the bone in the selected position without tying knots in the suture. 
 
     
     
       12. The method of  claim 11 , wherein
 the second member comprises a screw and moving the second member in the insertion direction comprises rotating the screw to advance the screw in the insertion direction. 
 
     
     
       13. The method of  claim 11 , wherein
 the second member comprises a plug and moving the second member in the insertion direction comprises using an impact force to advance the plug in the insertion direction. 
 
     
     
       14. The method of  claim 11 , comprising
 using a driver for moving the first member and moving the second member; and 
 wherein 
 the driver has a length and a width, 
 the length is greater than the width, 
 the length is parallel to the insertion direction, 
 the first member is supported by the driver, 
 the eyelet is transverse to the length, 
 the second member is supported by the driver, 
 the driver has a distal end and a proximal end, 
 the insertion direction corresponds to a direction from the proximal end toward the distal end, and 
 the first member is situated at least partially beyond the distal end of the driver, 
 the driver comprises a handle and a rod extending from the handle; 
 the rod includes a first shaft and a second shaft; 
 the first shaft facilitates inserting the first member in the bone; 
 the second shaft facilitates moving the second member in the insertion direction; and 
 the handle is at least partially moveable relative to at least the first shaft for moving the second shaft to cause the second member to move in the insertion direction. 
 
     
     
       15. The method of  claim 14 , wherein
 the second shaft is moveable relative to the first shaft for moving the second member in the insertion direction. 
 
     
     
       16. The method of  claim 11 , wherein 
       moving the suture comprises
 grasping the two free ends of the suture; and 
 pulling on the two free ends of the suture in an at least partially proximal direction to draw the soft tissue into the selected position. 
 
     
     
       17. The method of  claim 16 , wherein
 moving the second member into the suture securing position moves the second member into engagement with portions of the suture between the two free ends and the soft tissue; and 
 the portions of the suture are respectively pinned against a surface on the second member. 
 
     
     
       18. The method of  claim 16 , wherein the portions of suture are respectively pinned between the surface of the second member and the bone. 
     
     
       19. The method of  claim 16 , wherein
 the second member holds the portions of suture in a fixed position relative to the bone to thereby securely fasten the soft tissue in the selected position relative to the bone without tying knots in the suture. 
 
     
     
       20. The method of  claim 11 , wherein
 the first member comprises a loop of suture. 
 
     
     
       21. The method of  claim 11 , wherein moving the second member at least partially covers the eyelet of the first member.